Prognosis for Obamacare isn't improving much

People losing coverage; some must pay more

Fewer than 50,000 people had signed up for Obamacare by late last week in the 36 states that use the federal health care exchange, The Wall Street Journal reported Tuesday. The U.S. Department of Health and Human Services is expected to release national numbers this week, and they are expected to be underwhelming, too. The administration expected 800,000 would sign up for Obamacare by the end of November.

That huge gap is not surprising, considering the website is less accessible than Antarctica.

The problems may not be resolved by the administration's promised deadline at the end of the month. "Where we are is not where we want to be," Obamacare fix-it guru Jeff Zients said last week.

Losing October and November to the computer meltdown means that millions of people will have, at best, days to cram through the insurance enrollment system by Dec. 15 if they want coverage that begins on Jan. 1, writes James Capretta of the American Enterprise Institute.

If they can't, "it will be nearly impossible to process the enrollments fast enough to prevent breaks in insurance coverage at the beginning of 2014." Capretta's prediction: "some very large number of Americans – probably in the millions – will experience a break in insurance coverage at the beginning of 2014."

Most of the chaos has focused on the individual consumer market, in which millions of people have received cancellation notices or face higher premiums.

President Barack Obama has apologized for his oft-repeated promise that people who liked their doctors and policies could keep them. Many people are learning that they can't.

People who are covered through employer-sponsored insurance plans may believe they are shielded from the Obamacare surprises, but that might not be the case. Some 23 million to 41 million Americans have employer-sponsored plans that have or will change under the law, according to an analysis by McClatchy's Washington Bureau. That could usher in higher premiums and other cost hikes for those who are covered.

One of the biggest and most important Obamacare unknowns: Will young people sign up for coverage? If not, massively increased costs will outstrip pumped-up revenues, exerting tremendous financial pressure on the whole scheme.

Many young people will pay more for coverage than they do now. Carl Schramm, professor of entrepreneurship at Syracuse University, wrote in a recent Wall Street Journal op-ed that "a Manhattan Institute analysis of Health and Human Services numbers notes that a 27-year-old male will pay 99 percent higher premiums under Obamacare than he would under previously prevailing market rates.

"One reason is the law now limits insurers to charging the sickest seniors no more than three times the amount they charge their youngest customers. Given that 64-year-olds use on average six times as much health care as 19-year-olds, the Affordable Care Act forces young people to pay considerably more than the cost of their own care."

The reality of Obamacare comes into sharper focus every day. More Americans lose coverage or learn they'll have to pay much more.

A Silicon Valley SWAT team may rescue the website, but the only way to rescue the Affordable Care Act will be a complete congressional reimagining of the law.